鲑鱼降钙素鼻喷剂治疗绝经后骨质疏松患者骨密度及骨转换指标对照观察

目的:观察鲑鱼降钙素鼻喷剂在绝经后骨质疏松患者中的治疗效果及骨密度和骨转换指标的变化情况。方法:将80例绝经后骨质疏松症患者随机分为对照组40例和实验组40例。对照组采用阿仑膦酸钠治疗,实验组使用鲑鱼降钙素鼻喷剂治疗,疗程均为6个月,比较2组疗效及骨密度和骨转换指标的变化。结果:治疗前,2组骨密度变化、血Ca和血P水平差异不显著;治疗后,实验组血ALP、血BGP、尿Ca/Cr、尿HOP/Cr、尿DPD/Cr,显著低于对照组。结论:鲑鱼降钙素鼻喷剂能抑制绝经后骨质疏松患者骨吸收,增加骨量,值得推广使用。     

鲑鱼降钙素联合康复护理治疗老年骨质疏松骨痛的效果

目的观察鲑鱼降钙素联合康复护理对老年骨质疏松骨痛的治疗效果。方法将96例老年骨质疏松患者按随机数字表法分为治疗组与对照组,每组48例。对照组采用鲑鱼降钙素治疗,治疗组采用鲑鱼降钙素联合康复护理治疗,治疗后1、2、4、8周定期评估患者自我疼痛评价评分（VAS评分）。结果 2组患者治疗后VAS评分较治疗前均明显下降（P〈0.05）,临床症状均明显减轻;治疗组较对照组下降明显（P〈0.05）。总有效率对照组86.4%,治疗组92.7%,2组相比,差异有统计学意义（P〈0.05）。结论鲑鱼降钙素对缓解老年骨质疏松骨痛效果明显,联合康复护理治疗临床效果更好。     

补肾活血方对继发性肾性骨质疏松患者骨代谢标志物、骨密度及临床疗效的影响

目的探讨补肾活血方对继发性肾性骨质疏松患者骨代谢标志物、骨密度及临床疗效的影响。方法纳入我院2014年4月～2016年4月就诊的继发性肾性骨质疏松症患者81例为研究对象,以随机抽样法分为观察组与对照组,对照组在原发病疗法基础上肌肉注射鲑鱼降钙素50μg/d,2周后转为鼻喷剂(200IU/d),观察组在对照组基础上使用补肾活血汤进行治疗,连续进行12周。对比治疗前后患者疼痛得分、骨密度、骨代谢标志物及临床效果差异。结果两组患者治疗前的疼痛得分、1～4腰椎及股骨颈骨密度差异无统计学意义(P0.05),治疗后观察组疼痛得分低于对照组,骨密度高于对照组(P0.05);观察组患者的骨源性碱性磷酸酶、血清骨钙素、25-OH-VD水平高于对照组(P0.05),抗酒石酸酸性磷酸酶5b及Ⅰ型胶原羧基端肽β水平低于对照组(P0.05);观察组临床治疗总有效率高于对照组(P0.05)。结论常规疗法基础上使用补肾活血方能够改善患者骨痛症状,提升临床治疗效果,改善患者骨代谢水平,提升骨密度。     

补肾强骨汤治疗原发性骨质疏松症疗效观察

目的观察中药补肾强骨汤治疗原发性骨质疏松症的疗效。方法120例原发性骨质疏松症患者随机分为2组。对照组55例，采用维D钙咀嚼片、阿法骨化醇软胶囊、鲑鱼降钙素注射液及骨肽粉针四联抗骨质疏松治疗；治疗组65例，在对照组的基础上加用中药补肾强骨汤治疗。结果2组治疗后的骨密度值均明显高于治疗前，经统计学处理，有显著性差异（P〈O．01）。治疗组治疗后骨密度值提高程度明显高于对照组（P〈O．05）。结论中西医结合治疗原发性骨质疏松症疗效显著。     

鲑鱼降钙素对伴骨质疏松髋部骨折骨密度的影响

目的 观察肌注鲑鱼降钙素对并骨质疏松症的髋部骨折患者骨密度的影响。方法对69例髋部骨折的骨质疏松症患者进行为期3个月随机对照研究。用超声骨密度仪测定骨密度。结果治疗组治疗3个月后超声传导速度（SOS）值明显升高（P〈0．05）。对照组与治疗前比较，所测SOS值无明显变化（P〉0．05）。结论鲑鱼降钙素治疗骨质疏松症髋部骨折效果显著。     

鲑鱼降钙素联合护理干预治疗老年骨质疏松症60例疗效分析

目的:探讨鲑鱼降钙素联合护理干预对老年骨质疏松症患者骨痛及骨密度(BMD)的影响.方法:将120例老年骨质疏松症患者随机分为观察组和对照组各60例,对照组给予钙剂及维生素D药物治疗,观察组在此基础上加用鲑鱼降钙素及护理干预.比较两组干预前骨痛程度及BMD、治疗1个月后骨痛程度及治疗6个月后BMD变化.结果:治疗1个月后观察组骨痛程度改善明显优于对照组(P＜0.05),治疗6个月后观察组骨密度较对照组明显提高(P＜0.05).结论:鲑鱼降钙素联合护理干预能明显提高老年骨质疏松症患者的BMD,明显改善骨痛症状.     

壮骨活血颗粒联合鲑鱼降钙素对老年骨质疏松性腰椎骨折患者腰椎功能及骨密度的影响

目的探讨壮骨活血颗粒联合鲑鱼降钙素对老年骨质疏松性腰椎骨折患者腰椎功能及骨密度(BMD)的影响。方法选取我院收治的120例老年骨质疏松性腰椎骨折患者为研究对象,采用随机数字法分为参照组(60例,鲑鱼降钙素)和联合治疗组(60例,鲑鱼降钙素+壮骨活血颗粒)。比较两组治疗前、治疗3个月后伤椎前缘高度百分比、Cobb角、Oswestry功能障碍指数问卷表(ODI)评分、简化McGill疼痛问卷(SF-MPQ)评分、BMD、治疗3个月后的中医证候改善情况。结果治疗3个月后,两组伤椎前缘高度百分比、Cobb角均明显降低,且联合治疗组明显低于参照组(P<0.05)。两组的ODI、SF-MPQ评分均降低,且联合治疗组明显低于参照组(P<0.05)。两组BMD均升高,且联合治疗组明显高于参照组(P<0.05)。联合治疗组中医证候改善总有效率明显高于参照组(P<0.05)。结论壮骨活血颗粒联合鲑鱼降钙素对老年骨质疏松性腰椎骨折患者腰椎功能及骨密度的影响显著,值得临床推广应用。     

针刺联合骨质疏松治疗仪用于高龄骨质疏松患者对疼痛及骨密度的影响

目的 研究针刺联合骨质疏松治疗仪用于高龄骨质疏松患者的临床疗效,并观察其对患者疼痛和骨密度值的影响。方法 选取2020年1月至2021年12月贵州省骨科医院收治的96例骨质疏松患者为研究对象,按照随机数字表法分为对照组和观察组,各48例。对照组患者行骨质疏松治疗仪干预,观察组患者行针刺联合骨质疏松治疗仪干预。比较两组患者治疗效果,记录两组患者治疗前后血清因子水平,并比较疼痛程度和骨密度值。结果 观察组患者整体疗效显著优于对照组（P<0.05）。治疗后,两组患者雌二醇（E2）和骨钙素（BGP）水平均高于治疗前,总碱性磷酸酶（ALP）水平低于治疗前,且观察组患者E2、BGP水平高于对照组,ALP水平低于对照组（P<0.05）。治疗后,两组患者疼痛视觉模拟评分法（VAS）评分低于治疗前,骨密度值高于治疗前,且观察组患者VAS评分低于对照组,骨密度值高于对照组（P<0.05）。结论 针刺联合骨质疏松治疗仪用于高龄骨质疏松患者疗效显著,有助于调节骨代谢,减轻疼痛,改善骨密度值,值得临床应用。     

丙酸倍氯米松鼻喷剂治疗变应性鼻炎

目的：探讨丙酸倍氯米松鼻喷剂治疗变应性鼻炎的效果。方法：90例变应性鼻炎患者随机分为两组，其中治疗组50例，应用丙酸倍氯米松鼻喷剂喷鼻，2次／d，每次每孔2揿（50μg／揿）；对照组40例，应用曲安奈德鼻喷剂喷鼻，2次／d，每次每孔2揿（55μg／揿），疗程均为2周。结果：治疗1疗程后．大部分患者其症状与体征均有改善，治疗组总有效率为86．0％，对照组总有效率为87．5％，两组治疗前后均有显著差异（P〈O．05），两组间无显著差异（P〉0．05）。同时两组血清总IgE亦明显下降，治疗前后均有显著差异（P〈0．01）。结论。丙酸倍氯米松鼻喷剂局部应用治疗变应性鼻炎，见效快，效果好，无明显副作用，值得临床应用。     

鲑鱼降钙素对绝经后骨质疏松症疼痛的疗效观察

目的：观察鲑鱼降钙素对绝经后骨质疏松症疼痛的疗效。方法：对９６例骨质疏松症患者，应用鲑鱼降钙素５０Ｕ隔日肌注１次，连续１个月，后改用鲑鱼降钙素鼻喷剂每日２００Ｕ持续半年。同时每日口服元素钙１０００ｍｇ。结果：９６例患者用药后总有效率为９３．７％；疼痛改善时间最快治疗后４ｈ。治疗半年后腰背痛积分平均值明显降低（Ｐ〈０．０５）。治疗前后骨代谢生化指标比较，血碱性磷酸酶、骨钙素升高；尿羟脯氨酸／肌酐比值     

A comparison of the acute effects of subcutaneous and intranasal calcitonin

1. We studied the acute effects of intranasal and subcutaneous calcitonin in 40 patients with active Paget's disease of bone. Patients received a single dose of either 400 units of calcitonin delivered as a nasal spray, or 1, 10 or 100 units of subcutaneous calcitonin, or placebo. 2. Subcutaneous salmon calcitonin, administered at doses of 1, 10 and 100 units to nine patients with Paget's disease of bone, induced a dose-dependent fall in the serum calcium. This calcium-lowering effect was not seen with a second group of nine patients receiving placebo. 3. The lower doses of calcitonin had significant effects, and these were more pronounced in patients with lower rates of bone turnover. 4. Four hundred units of calcitonin administered as a nasal spray induced effects qualitatively similar to those seen with subcutaneous calcitonin, with an efficacy equivalent to approximately 30 units of subcutaneous calcitonin. 5. We conclude that the bioequivalence of calcitonin given by intranasal insufflation is low compared with its parenteral administration. The intranasal route may be more appropriate for managing patients with disorders associated with low bone turnover.     

The effect of adding calcitonin to physical treatment on reflex sympathetic dystrophy.

The efficacy of intranasal salmon calcitonin was examined in a double-blind randomized study in reflex sympathetic dystrophy. Sixty-six patients were randomly divided in two groups receiving physiotherapy. In addition group I also received 3 x 100 U/day of salmon calcitonin by intranasal spray whereas group II received 3 sprays of placebo. The pain and the range of motion were improved by calcitonin administration. Similarly the patients' ability to work was also improved. The results confirmed that salmon calcitonin has an effect but that this effect was not equally observed on all parameters analyzed. It was most marked on pain (at rest and on movement) and on the ability to work.     

中药骨补方对骨质疏松症患者疼痛及骨密度的影响

目的研究中药骨补方对骨质疏松症患者的疼痛及骨密度的影响,从而为临床应用骨补方治疗骨质疏松症提供可靠依据。方法选择门诊120例,分为治疗和对照两组,每组60例,治疗组:中药骨补方+降钙素+钙剂;对照组:降钙素+钙剂:15d为1个疗程,治疗3个疗程后观察疼痛缓解情况及骨密度的改善情况及副作用。结果A组疼痛极点由治疗前的1.97降至1.06(P<0.01)。骨密度较治疗前有显著改善(P<0.01)。B组疼痛极点由治疗前的1.76降至1.64(P>0.05),骨密度较治疗前有改善(P<0.05),两组的疼痛缓解及骨密度改善有明显差别(P<0.05)。结论中药骨补方对骨质疏松症患者的疼痛缓解和骨密度的改善作用明显,无副作用。     

COMPARISON OF ALENDRONATE,CALCITONIN AND CALCIUM TREATMENTS IN POSTMENOPAUSAL OSTEOPOROSIS

The present study was planned to assess the safety, tolerability and efficacy on bone mineral density (BMD), pain, quality of life and fracture risk of alendronate, calcitonin and calcium treatments. A total of 151 postmenopausal women with lumbar spine BMD 2 SD or more below the young adult mean were randomly assigned to one of three groups: 51 patients received oral alendronate 10 mg and calcium 1000 mg (alendronate group), 50 patients intranasal salmon calcitonin 100 IU and oral calcium 1000 mg (calcitonin group), and 50 patients oral calcium 1000 mg (calcium group) daily for one year. BMD was assessed by dual energy X-ray absorbtiometry, pain by a visual analogue scale, and quality of life by the Nottingham health profile. Significant increases in BMD at all sites were obtained in the calcitonin and alendronate groups, but not in the calcium group. Pain and quality of life improved significantly in both the calcitonin and alendronate groups, but not in the calcium group. New vertebral fractures were seen in 31.58% of the alendronate, 37.5% of the calcitonin, and 40% of the calcium groups, representing no statistical difference. No serious side-effects were seen in any of the patients during follow-up.     

补肾活血方治疗肝肾亏虚型绝经后骨质疏松症临床观察

目的:探讨补肾活血方治疗肝肾亏虚型绝经后骨质疏松症患者的临床疗效。方法:纳入符合标准的绝经后骨质疏松症(PMO)患者共80例,中医辨证为肝肾亏虚证。治疗组患者口服补肾活血方治疗,对照组通过肌注降钙素治疗。治疗3个月后观察患者疼痛缓解状况、骨密度测定以及血磷血钙值测定。结果:治疗后,对照组和治疗组的VAS评分均降低,与治疗前相比,差异有统计学意义。治疗后2组骨密度值较治疗前有所升高,差异有统计学意义。治疗后2组血磷血钙值较治疗前明显下降,差异具有统计学意义。治疗组有效率为82.50%,对照组有效率为62.50%,组间对比差异有统计学意义。结论:运用中药汤剂补肾活血方可以明显缓解肝肾亏虚型绝经后骨质疏松患者的疼痛症状,提高患者骨密度值,降低血磷血钙值。     

Calcitonin load test to assess the efficacy of salmon calcitonin

BACKGROUND: Monitoring treatments of osteoporosis is required to identify patients not responding to the treatment in a way that reflects mechanism of action of the antiresorption drug on bone. Neither bone mineral measurement nor the available biochemical markers of bone remodeling can be used to monitor efficacy of treatment with nasal spray salmon calcitonin (sCT) since the changes in individual patients are modest and do not exceed the least significant change. METHOD: The novel calcitonin load test (CLT) was developed to assess the biological response to sCT in postmenopausal osteoporotic women. The CLT is based on the time course and an extent of suppression of serum C-terminal telopeptide of types I collagen (CTX) after the intranasal and subcutaneous administration of sCT. The CLT was conducted in 30 untreated postmenopausal osteoporotic women (control group, mean age, 67.7+/-8.4 years), and in 120 postmenopausal osteoporotic women (mean age, 68.5+/-8.1 years) treated with 200 IU of sCT (Miacalcic Nasal, Novartis, Switzerland), for up to 8.4 years (mean, 3.5+/-2.1 years). RESULTS: After 90 min from the intranasal administration of 400 IU of sCT, a decrease (p<0.01) in serum CTX by 58+/-11% was found in the control group, and by 60+/-11% in 74% of the treated patients. In the remaining treated patients, the decrease in CTX did not exceed the least significant change. The number of patients not responding to the CLT increased with duration of the treatment up to 34% in patients treated for over 4 years. Of the non-responders to the nasal spray sCT, 63% failed to respond to the subcutaneous administration of 10 IU of sCT. In the treated group, a significant negative correlation has been found between the percentual changes in CTX from its baseline levels detected during the CLT, and a rate of changes in the femoral neck BMD (p<0.01). CONCLUSION: The CLT can be used as a tool to identify patients that respond to administration of CT, and will profit from a continued treatment with sCT.     

密固达联合护理干预治疗老年骨质疏松症的疗效观察

[目的]观察密固达（唑来膦酸注射液）联合护理干预对老年骨质疏松症病人骨痛及骨密度（BMD）的疗效.[方法]将90例老年骨质疏松症病人随机分为观察组和对照组各45例,对照组给予口服钙剂及维生素D,观察组在此基础上加用密固达联合护理干预综合治疗.比较两组治疗前后骨痛程度及BMD变化.[结果]观察组治疗后骨痛症状缓解,与对照组总有效率比较差异有统计学意义（P〈0.05）;观察组治疗后骨密度增加,与对照组比较差异有统计学意义（P〈0.05）.[结论]密固达联合护理干预能有效提高老年骨质疏松症病人的BMD,改善骨痛症状.同时,通过护理干预能使病人积极配合治疗和护理.     

康复训练与药物联合对脑卒中偏瘫后患者继发性骨质疏松的预防作用

目的观察和分析康复训练与药物联合对脑卒中偏瘫后患者继发性骨质疏松的预防作用。方法选择2010年6月-2012年6月本院住院治疗的120例脑卒中后偏瘫患者作为研究对象,随机分为观察组和对照组,每组各60例。对照组在常规疗法基础上应用康复运动训练进行治疗,观察组在对照组疗法基础上联合应用鲑降钙素、碳酸钙D3片进行抗骨质疏松药物治疗,检测和比较2组患者入组时,治疗后1个月、3个月偏瘫侧股骨近端Ward三角、桡骨远端、第1腰椎骨的骨密度情况。结果2组患者3个检测部位的入组时骨密度差异无统计学意义（P〉0．05）;而治疗后1个月和3个月,观察组患者3个检测部位的骨密度均显著高于对照组（P〈0．05）。结论联合应用药物与康复训练对脑卒中偏瘫后患者继发性骨质疏松可起到显著的预防作用。     

临床路径护理干预对骨质疏松患者疗效的临床分析

目的探讨临床路径护理（CP）对骨质疏松症（OP）患者骨密度及其他指标的影响。方法将178例患者按区组随机化分组方法分为研究组和对照组;对照组实施骨质疏松症常规护理,研究组则实施临床护理路径,观察对比2组患者180d后骨密度及其他指标的变化。结果 180d后研究组患者的治疗效果、骨密度、平均住院时间、住院费、骨折发生率、患者满意度、生活质量评分和治疗依从性等与对照组比较,差异均有统计学意义（P〈0.05）。结论在骨质疏松症患者中实施临床护理路径能有效改善患者骨痛症状、在一定程度上可提高患者骨密度,缩短平均住院时间,降低住院费和骨折发生率,显著提高患者满意度、生活质量评分和治疗依从性,值得临床推广。